Zhang et al reported a prognostic model for a patient with acute decompensated cirrhosis. This can help to identify a patient who may benefit from more aggressive management. The authors are from Nanchang University in China.
Patient selection: acute decompensated cirrhosis
Parameters:
(1) age in years
(2) serum total bilirubin in µmol/L
(3) INR
(4) WBC count in 10^9/L
(5) serum albumin in g/L
(6) serum ALT in IU/L
(7) serum urea in mmol/L
Parameter
Points
age in years
0.022 * (age)
serum total bilirubin
0.003 * (bilirubin)
INR
0.39 * (INR)
WBC count in 10^9/L
0.023 * (WBC)
serum albumin
-0.07 * (albumin)
serum ALT in IU/L
0.001 * (ALT)
serum urea in mmol/L
0.038 * (urea)
total score =
= SUM(points for all of the parameters)
Interpretation:
• The cutoff was 0.68, separating low risk from high risk.
• The 6-month survival rate was 50% in the high-risk group vs 92% in the low-risk group.
Performance:
• The area under the ROC curve was 0.81.
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